Individual
MISS ANDREA LYNN TAFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
221 VILLA LN, SAINT CLAIR SHORES, MI 48080-2737
(269) 370-4846
Mailing address
1469 CANAL ST, PORTAGE, MI 49002-7524
(269) 370-4846
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005888
MI
Other
Enumeration date
09/24/2010
Last updated
08/07/2025
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